Credentialing/provider enrollment account manager (full time)

Responsibilities:

Client Facing:

• Oversee the completion and submission of provider enrollment applications for all clients (providers)
• Manage the clients assigned to them, being the client's primary point of contact, and delegating and assigning tasks and projects to the offshore team daily.
• Manage all phases of provider enrollment, re-enrollment, contracting, fee schedule review and negotiations, and expirable management ensuring the timely and accurate enrollment (and recredentialing) of providers into various payers.
• Coordinate in obtaining necessary data needed for enrollment, contracting, and other related purposes from clients/providers including signatures and missing documentation.
• Contacting payer(s) by phone, requesting network participation and follow up on submitted applications.
• Coordinate all initial enrollment and re-enrollment applications, including revalidations for Medicare and/or Medicaid as requested.
• Maintain the timelines on enrollment/credentialing schedules, communicate with providers and other departments to update as needed, clarify carrier information requirements, and maintain a strict level of confidentiality for all matters pertaining to provider credentials.
• Provide each client a weekly status report and upload into STAT (Knack proprietary software).

Operations (Offshore Interaction):

• Delegate projects and tasks to the offshore team and manage turnaround time, and quality of the completed work.
• Provide instructions to offshore on how to manage all data within the software.
• Meet and train offshore staff as necessary. Direct the offshore team on which payer(s) to contact for follow-up, request network participation, and monitor submitted applications. Develop or update the training program for both onshore and offshore teams.
• Communicate with offshore team to process all initial enrollments and re-enrollment applications, including revalidations for Medicare and/or Medicaid as requested by client.
• Provide offshore a list of clients and projects to follow up on a weekly basis.
• Provide feedback to minimize errors and enhance processes by analyzing operational data and metrics
• Create, update, and maintain standard operating procedures (SOPs) for credentialing operations.
• Serve as primary contact for resolving escalated issues
• Stay up to date with all requirements for all services to ensure compliance and adapt processes as necessary

Key Skills:

• Anticipate customer needs and proactively identify solutions.
• Work independently and as a team solve complex problems.
• Provide utmost customer service.
• Adapt well in a changing environment.
• Extensive computer and software experience is necessary.
• Strong Leadership and team management skills
• Excellent analytical and problem-solving skills

Requirements:

• 5+ years of experience in credentialing, provider enrollment, or healthcare operations
• Experience working with federal and commercial payers, understanding their specific credentialing requirements and processes.
• Familiarity with healthcare regulations, accreditation standards, and compliance issues related to provider credentialing
• Excellent communication and organizational skills.
• Experience in collaborating with offshore team preferred.
• Remote work US business hours from 8 am to 5 pm EST.
• International travel to India (2-3 weeks in a year) if needed.

This is a full-time role with full Benefits (Medical, Dental, Vision, 401K, 401K match, PTO)

About Knack Global:

Knack Global is a leading provider of comprehensive revenue cycle management services dedicated to transforming the healthcare industry.

Founded in 2007, Knack Global has grown into a trusted partner for healthcare providers and physician practices. Our journey began with a vision to bridge the gap between healthcare services and financial processes. We have a team comprised of highly skilled professionals with diverse expertise in healthcare administration who deliver end-to-end RCM Services and solutions including practice management, credentialing, billing, and receivables management.